Efficacy and safety of topical ruxolitinib cream for the treatment of vitiligo: a systematic review and meta-analysis of randomized controlled trials

Vitiligo is an autoimmune condition with an estimated prevalence of 0.5%–2% worldwide.1 Besides the visible cosmetic concerns associated with vitiligo, it is marked by psychological concerns such as anxiety and distress leading to reduced quality of life.1 The disease is known to be mediated by interferon-gamma (IFN-γ) which acts through the Janus kinase-signal transducer and activator of transcription (JAK–STAT) pathway to recruit CD8+ T cells, which in turn drive the cytotoxicity directed against melanocytes via detachment and apoptosis, leading to the characteristic white skin patches.1 Ruxolitinib acts as a JAK1 and JAK2 inhibitor to suppress the IFN-γ-mediated pathway and prevent melanocyte damage, allowing them to heal and re-pigment.2 Phase 3 trials of ruxolitinib have recently been published and demonstrate encouraging outcomes in vitiligo patients. This meta-analysis aims to systematically collate outcomes from the relatively limited data available and evaluate the efficacy and safety of ruxolitinib in vitiligo patients.